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NeuralgiaPhase 2NCT01485094

A Study to Assess the Safety and Efficacy of 7 Days Treatment With a Novel Analgesic in Subjects With Peripheral Neuropathic Pain

A Phase 2 study testing GRT6010 and Pregabalin in people with Neuralgia, run by Grünenthal GmbH at 12 sites in 4 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this trial is to determine whether a novel analgesic is effective in treating of neuropathic pain caused by herpetic infection, surgery, or trauma. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Neuralgia
What is being tested?
GRT6010 and Pregabalin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
114 participants
Where
12 sitesin 4 countries
Study dates
Feb 2012to Jan 2013
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 years to 75 years
  • Presence of persistent neuropathic pain for at least 6 months at the time of the Enrollment Visit. Allowed reasons for neuropathic pain are: modified radical mastectomy, breast conserving surgery, or cosmetic breast surgery. [Germany: subjects after cosmetic breast surgery may not be enrolled.]
  • Presence of "probable" or "definite" neuropathic pain.
  • Presence of dynamic mechanical allodynia on the affected side, or alternatively, the mechanical pain sensitivity for any of the pinprick stimuli is higher on the affected compared to the contralateral side.
  • At either Visit 5 or Visit 6: Presence of an average evoked pain intensity score of >20 on the 0 100 point numeric rating scale (NRS) for at least 1 of the 3 clinical sub-tests for dynamic mechanical allodynia (i.e., standardized brush, cotton wool tip or cotton wisp). The average will be calculated as the arithmetic mean of all measurements per sub test. Alternatively, the arithmetic mean of the 5 test replicates for any of the pinprick stimuli for mechanical pain sensitivity is at least 3 times higher for the affected side compared to the contralateral side.
  • Presence of an average ongoing pain intensity score of >4 to <9 on the 0-10 point numerical rating scale (NRS) without the use of rescue medication within the 3 day Baseline pain intensity evaluation Period with at least 7 of 9 assessments being present.
  • Dissatisfaction with the current treatment (i.e., lack of efficacy or intolerable side effects) if taking an opioid or non opioid analgesic medication for the painful neuropathy before enrollment.

Who cannot join

  • Any kind of hepatic impairment at Visit 1 or at Visit 3.
  • Either active hepatitis within the past 3 months or presence of chronic hepatitis irrespective of its activity status.
  • Estimated creatinine clearance of less than 60 mL/minute x 1.73 m2 at either Visit 1 or at Visit 3.
  • Clinically relevant cardiac disease (e.g., unstable angina pectoris, angina pectoris Canadian Cardiovascular Society [CCS] Grade III to IV, acute myocardial infarction within the last 3 months, cardiac insufficiency New York Heart Association [NYHA] Class III to IV).
  • Electrocardiogram (ECG) with clinically relevant findings at either Visit 1 or at Visit 3, including but not limited to repeated prolongation of QTc > 450 ms (Fridericia correction), or a history of additional risk factors for torsade de pointes (e.g., family history of Long QT Syndrome).
  • Clinically relevant pulmonary disease (e.g., Medical Research Council breathlessness scale of 2 or above).
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  • Specific antitumor therapy within the last 6 months, e.g., adjuvant radiotherapy or chemotherapy, biologics, or angiogenesis inhibitors.
  • CYP2D6 poor metabolizer phenotype as predicted by CYP2D6 genotyping.
  • Presence of confounding pain conditions (e.g., ulnar nerve entrapment, radial nerve injury associated with major soft-tissue or bone damage, cervico-thoracic radiculopathy, carpal tunnel syndrome, chemotherapy-induced peripheral neuropathy, or complex regional pain syndrome type I or type II).
  • Phantom breast or phantom limb pain.
  • Presence of exclusively negative symptoms of neuropathic pain (e.g., hypoesthesia or total anesthesia) in the affected area.

Trial locations and contacts

12 sites in 4 countries.

12 sites in 4 countries

Hungary4 sites
  • HUN004

    Esztergom, H-2500

  • HUN003

    Győr, H-9024

  • HUN001

    Miskolc, H-3526

  • HUN008

    Szikszó, H-3800

Other trials in Hungary

Poland3 sites
  • POL002

    Gdansk, 80-214

  • POL004

    Lublin, 20-718

  • POL005

    Warsaw, 02-106

Other trials in Poland

United Kingdom3 sites
  • GBR003

    Belfast, BT2 7BA

  • GBR001

    Glasgow, G11 6NT

  • GBR002

    Manchester, M32 0UT

Other trials in United Kingdom

Germany2 sites
  • DEU001

    Mainz, D-55131

  • DEU002

    Regensburg, D-93053

Other trials in Germany

About this study

Official title: Evaluation of the Efficacy, Tolerability, and Safety of 7 Days of Treatment With GRT6010 or Pregabalin in Comparison to Placebo in Subjects With Peripheral Neuropathic Pain.

The purpose of this trial is to determine whether a novel analgesic is effective in treating of neuropathic pain caused by herpetic infection, surgery, or trauma.

Read the detailed description

This trial evaluates the effectiveness of a novel analgesic in peripheral neuropathic pain in a mixed patient population. Participants were treated for one week and randomly assigned to the novel analgesic, pregabalin, or placebo. Pain will be characterized before and at the end of this period. This trial required the participants to stay at the investigational site for 14 consecutive days.

The enrollment visit took place Day -28 to Day -16. Participants tapered down their existing medication from Visit 2 (Day -17 to Day -5) to Visit 3 and were given rescue medication (paracetamol/acetaminophen). At Visit 3 participants were hospitalized (Day -4). The baseline evaluation period took place from Day -3 to Day -1. Randomization to one of the three treatment arms was possible after the last assessment on Day - 1 alternatively randomization took place on Day 1. This was followed by the double-blind treatment period (Day 1 to Day 7). The participants were follow-up thereafter up to day 36 (Day 34 to 38). Participants were permitted to resume their previous medication.

Conditions
Neuralgia
Being tested
GRT6010, Pregabalin, Matching Placebo
Keywords
neuralgia, postherpetic
Medical subject headings
Neuralgia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • GRT6010Drug

    Oral solution given once daily.

  • PregabalinDrug

    Also called Lyrica®

    Over-encapsulated pregabalin capsules 75mg twice daily on Days 1 to 3, and 150mg twice daily on Days 4 to 7.

  • Matching PlaceboDrug

    Matching Placebo capsules to the over-encapsulated Pregabalin capsules and Matching Placebo oral solution to the GRT6010 solution.

    Capsules twice daily on Days 1 to 7. Solution once daily.

Study groups in NCT01485094
Study groupRoleWhat they receive
Matching placeboPlacebo comparatorOral administration. Pain not sufficiently controlled may be treated with acetaminophen.
Receives: Drug: Matching Placebo
GRT6010ExperimentalOral administration. Pain not sufficiently controlled may be treated with acetaminophen.
Receives: Drug: GRT6010
PregabalinActive comparatorOral administration. Pain not sufficiently controlled may be treated with acetaminophen.
Receives: Drug: Pregabalin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Difference Between Baseline and End-of-double-blind Treatment Ongoing Pain Intensity Scores

    The baseline pain intensity score was calculated as a mean of pain intensity scores during the Baseline Period (from Day -3 to Day -1). The ongoing pain intensity data from Day-3 to Day 7 was used. For the analysis, only pain scores on days where participants received study drug were considered. The primary efficacy analysis of the ongoing pain intensity score were analyzed in a Bayesian framework, via a mono exponential decay model, with the baseline Numeric Rating Score (NRS) as intercept. Considering the inclusion criteria of baseline pain intensity being in the range from 4 to 9, the range in ongoing pain intensity difference between baseline and end-of-double-blind treatment can be from 6 (worst possible value) to -9 (best possible value). A negative value indicates improvement whilst on the treatment.

    Measured: Baseline; Day 7 (end of double blind treatment)

  2. The Difference Between Baseline and End-of-double-blind Treatment Brush-evoked Pain Intensity Scores

    The difference between baseline and end-of-double-blind treatment brush-evoked pain intensity scores compared to placebo on a 0-100 point NRS (measured as part of the dynamic mechanical allodynia assessments).

    Each participant rated each brush-evoked pain intensity on a 0 to 100 point Numerical Pain Rating Scale, with 0 indicating 'No Pain' and 100 indicating 'most intense pain imaginable'. Lower values compared to an individual subject's baseline are an improvement in symptoms.

    The baseline brush-evoked pain intensity score was defined as the average of the geometric mean of all of the values obtained on Day -2 and Day -1, and compared with the scores obtained on day 6 and 7.

    For the analysis, only pain scores on days where participants received study drug were considered.

    A negative change indicates a decrease in brush-evoked pain intensity from baseline.

    Measured: Baseline and day 7 (end of double blind treatment)

Secondary outcomes (10)
  1. Assessment of Responder Rates

    The assessment was performed on Day 7.

    The percentage of change from baseline (Day -3 to Day -1, i.e. the 3 days in the days prior to first dose) in the daily ongoing pain intensity was calculated at Day 7.

    The percentage of change from baseline in the daily ongoing pain intensity was calculated at Day 7 as follows:

    % change = (Baseline Pain Intensity - Daily pain intensity at treatment visit) / Baseline Pain Intensity × 100

    The threshold values represent an improvement in ongoing pain intensity greater than 20, 30, 40, 50, 60, 70, 80 or 90% as per calculation.

    Participants who showed a worsening in their daily pain intensity or who prematurely discontinued the trial were regarded as non-responders in terms of the respective treatment.

    Measured: Day 7 (end of double blind treatment)

  2. Onset of Current Pain Relief

    Onset of current pain relief defined as the first time-point at which the participant reports a decrease of a 1-point reduction in current pain relative to baseline (day -3 to day -1), after start of treatment with study drug on Day 1.

    Due to the early termination of the trial this analysis was not performed.

    Measured: Day 1 to Day 7 (end of double blind treatment)

  3. Onset of Ongoing Pain Relief

    Onset of ongoing pain relief defined as the first time-point at which the participant reports a decrease of more than 1-point reduction in ongoing pain relative to baseline (day -3 to day -1), after start of treatment with study drug on Day 1. Study drug intake started on Day 1.

    Due to the early termination of the trial this analysis was not performed.

    Measured: Day 1 to Day 7 (end of double blind treatment)

  4. Change in Neuropathic Pain Symptom Inventory Scores on Day 7 From Baseline (Day -1)

    The Neuropathic Pain Symptom Inventory (NPSI) Score is an assessment of neuropathic pain symptoms.

    A participant answered 10 questions on an 11-point scale 0 (no pain) to 10 (most intense pain imaginable).

    The total NPSI score is the sum of all ten responses and ranges between 0 and 100.

    The baseline score and the mean NPSI change is reported over the double-blind treatment period. A negative mean change in score on Day 7 indicates an improvement on this 0 to 100 point scale from baseline for the total score.

    For pain descriptions burning, pressing, paroxysmal (pain like electric shocks or stabbing), evoked (due to touch) and paresthesia (sensation that is not unpleasant) or dysesthesia (unpleasant) subscores a negative mean change indicate an improvement on the 11 point scale. A participant will score 10 to indicates the worst imaginable symptom, e.g. worst burning imaginable. A participant will score 0 if there is no burning, i.e. the symptom is absent.

    Measured: Day -1; Day 7 (end of double blind treatment)

  5. Difference in Patient's Global Impression of Change

    In the Patient Global Impression of Change (PGIC) the participant indicates the perceived change over the 7 day treatment period. The participant is requested to choose one of seven categories. Scores range from very much improved to very much worse.

    Measured: Day 7 (end of double blind treatment)

  6. The Difference Between Baseline and End-of-double-blind Treatment Scores for Dynamic Mechanical Allodynia and Mechanical Pain Sensitivity Compared to Placebo

    Allodynia is pain due to a stimulus that does not normally provoke pain. Dynamic mechanical allodynia was assessed using a set of 3 light tactile stimulators as moving innocuous stimuli.

    Each participant gave numerical pain ratings for each of 15 stimuli at the affected side.

    Mechanical pain sensitivity was assessed using a set of 7 weighted pinprick stimuli to obtain the stimulus-response function for pinprick-evoked pain.

    The participant gave a numerical pain ratings for each of 35 pinprick stimuli at the affected site.

    Dynamic mechanical allodynia and mechanical pain sensitivity was calculated as the geometric mean of all numerical ratings. The values obtained on Day -2 and -1 were taken as the baseline and values on Day 6 and 7 were taken as the end of treatment. A negative change indicates an improvement on the 0 (no pain) to 100 point scale, where 100 indicates the worst imaginable pain.

    Measured: Day 7 (end of double blind treatment)

  7. Change in Area of Static Allodynia and Dynamic Allodynia From Baseline

    Allodynia is pain due to a stimulus that does not normally provoke pain. To measure the areas of dynamic and static allodynia, a point lying in the center of the area of maximum pain was marked at baseline (Day -2 and -1). From the baseline point, 8 radii were drawn.

    The area of dynamic allodynia was determined by gently stroking the skin with a standardized brush along the lines. The participant was asked to report when the sensation became unpleasant.

    The area of static allodynia was determined by a 128 mN (millinewton) pinprick stimulus along the lines of the 8 radii while asking the subject to report when the sensation became unpleasant.

    The area was calculated from the summing of the 8 triangles that are generated from the points along each of the 8 radii at which unpleasantness was reported. The larger the area in square centimeters the more allodynia. A reduction in the area of allodynia indicates improvement.

    Measured: Baseline; Day 7 (end of double blind treatment)

  8. Difference in Leeds Sleep Evaluation Questionnaire After 7 Days of Treatment

    On the last day of the double-blind treatment period sleep was evaluated using the Leeds sleep evaluation questionnaire. This questionnaire has 10 self-rating 100 mm line analogue questions concerning sleep and early morning behavior. The higher the score, i.e. the closer the value is to 100 the worse the rating by the participant.

    The 10 responses are grouped into 4 subscores:

    • The ease of getting to sleep.
    • The perceived quality of sleep.
    • The ease of awakening from sleep.
    • The integrity of behavior following wakefulness.

    Measured: Day 7

  9. Change in painDETECT Grading From Baseline (Day -1) to End of Double-blind Treatment (Day 7)

    The painDETECT questionnaire was used to determine the possibility of the presence of a neuropathic pain component. It is a participant completed questionnaire. A total score is calculated between 0 and 38 for each participant. Participants with a score between 0 and 12 are graded as "negative" and having "no neuropathic pain component". Scores between 19 and 38 result in a "positive" grading, in other words having "presence of neuropathic component". Values from 13 to 18 result in participants being graded as having an "unclear" neuropathic component to their pain. The painDETECT questionnaire was first administered on Day-1 (baseline). The data reported is for before treatment start (Day -1) and the change from baseline on Day 7 (end of the double-blind period).

    Measured: Day 7 (end of double blind treatment)

  10. Daily Current Pain Intensity

    Participants recorded their current pain intensity score 3 times a day, using a 0 -10 (11 point) Numeric Rating Scale where a rating of 0 corresponded to "No Pain" and a rating of 10 to "Pain as bad as you can imagine".

    The daily current pain intensity reported was derived as the mean of the 3 current pain intensity assessments taken on the day from all participants in the treatment group.

    The lower the value on the 11 point scale the less pain was reported on a treatment.

    Measured: Baseline; Day 10

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Dec 2011 (estimated)
  2. Study startFeb 2012
  3. Primary completionJan 2013
  4. Study completionJan 2013

Why it stopped: The trial was early terminated after it was concluded that there was no added benefit from exposing further participants after an unblinded interim analysis.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
114 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01485094
Sponsor's protocol ID
967165
Other IDs
2011-002092-42
Status last verified
Oct 2019
First submitted
5 Oct 2011
Last updated
28 Oct 2019
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing GRT6010 and Pregabalin in people with Neuralgia, run by Grünenthal GmbH at 12 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 28 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in Hungary, Poland, United Kingdom, Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 2 Oct 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference Between Baseline and End-of-double-blind Treatment Ongoing Pain Intensity Scores (time frame: Baseline; Day 7 (end of double blind treatment)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Oct 2019.

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